A NEW VITAMIN-LIKE ACTIVATOR
The seriousness of the dental caries problem in relation to both human progress and the dilemma of modern physical degeneration emphasizes the need of a bird’s-eye view of the problems involved in restoring to man his original immunity.
For the entire period of human life on the earth, say one million years, some human skeletons have been preserved in burials. A study of these remains reveals that there has been more dental caries in the last hundred years than at any time previously and probably more than during any thousand-year period of his history. This situation suggests, if it does not demand, that we analyze critically the changes in man’s environment and his interference with it.
As to our present knowledge of the problem, we find it evaluated in the recently published summary made by the Research Commission of the American Dental Association. Two hundred thirty-seven investigators and observers present their best judgment and experience in 276 pages. In this detailed report, we see that there is no recognized theory regarding the etiology of dental caries and no accepted program for the control of the disease. So far as progress is concerned, there is much evidence that, in general, the situation is getting worse from decade to decade.
While outstanding progress has been made in the knowledge of disease in general knowledge that places great emphasis on the rôle of nutrition in modern degeneration that splendid progress has revealed the nature and rôle of many of its new factors, especially vitamins. It is profoundly significant, however, that no single vitamin or combination of vitamins has completely solved the riddle of dental caries or pointed the way to a determination of its etiology. This suggests our ignorance as regards any specific substance for use in controlling dental caries. There must be some food substance that is not adequately provided in modern nutrition, perhaps owing to some fundamental change in quality, preparation or selection of the substance. To judge from the skeletal remains, people of the past obtained a substance that modern generations do not have. The present report will present evidence of a heretofore not generally recognized activating substance. It is not one of the recognized vitamins, but is a substance which belongs in the fat-soluble group.
The data to be presented will indicate that: (a) it plays an essential role in the maximum utilization of body-building minerals and tissue components; (b) its presence can be demonstrated readily in the butterfat of milk of mammals, the eggs of fishes and the organs and fats of animals; (c) it has been found in highest concentration in the milk of several species, varying with the nutrition of the animal, and (d) it is synthesized by the mammary glands and plays an important role in infant growth and also in reproduction.
In 1926, Yoder1 published a report on the “Relation Between Peroxidation and Antirachitic Vitamins,” including a chemical procedure for determining antirachitic potency. When Vitamin D was separated from vitamin A, its rôle included the functions of activated ergosterol, which came to be known as vitamin D. While Yoder’s peroxidation method was early used as a chemical test for vitamin D, it was later found that it measured a nutritional factor much broader than its antirachitic function.
In my early reports on the vitamin content of dairy products,’ I used this test as a measure of the vitamin D content. My data revealed that the nutritional factor it represented included aids to mineral utilization, as well as potency for dental caries immunity. I have accordingly used this method for testing the value of foods, particularly dairy products, for potency in controlling dental caries, and of associated health factors. In my early reports on the levels of this activating substance in butter as measured by the chemical test reported by Yoder, I expressed the values as vitamin D; but, as my studies progressed, it was revealed clearly that the qualities which I was concerned with in butter were not comparable to vitamin D as represented by ergosterol that had been exposed to ultraviolet radiation. Since butter contained definite nutritional qualities not provided in irradiated ergosterol in addition to its antirachitic properties, I accordingly dropped the term vitamin D, as expressed in Yoder’s test, and, for want of a better means of identification, used in my records the term activator X.
Since an acceptable chemical test for vitamin A that depended on the action of antimony trichloride in choloroform solution had been developed by Carr and Price, I made an extensive number of studies of the vitamin A and activator X content of a large series of butter samples obtained from many states and provinces and from different countries throughout the world. These studies were related to two other important studies; namely, sunshine curves and mortality data from various districts. These studies, which have now been in progress since 1928, include an analysis of more than 20,000 samples of dairy products. In order to establish wide application of the data, samples were received every two to four weeks from several different parts of the world over a period of several years. These included samples from districts of the United States, northwestern Canada, Australia, Brazil and New Zealand.
It was quickly disclosed that neither total hours of sunshine nor temperature was the chief controlling factor. The factor most potent was found to be the pasture fodder of the dairy animals. Rapidly growing grass, green or rapidly dried, was most efficient. It was disclosed that these periods of growth were directly related to the rains and harvest, and, for the southern states, there were two distinct peaks in the vitamin and activator curves, one in the spring and the other in the autumn. In general, in moving northward through the United States and through the Canadian provinces, these two peaks came closer together and the total for the maximum rise was much higher in the northern dairy districts than in the southern. By obtaining samples over a very wide range, curves for vitamin A and activator X, as shown combined in Figure 135, were made for the products analyzed from various provinces of the United States and Canada. The total area was divided into sixteen divisions, each representing several thousand square miles.
A study of the data of the health departments of all these districts regarding mortality for heart disease and pneumonia disclosed that the curves were always found to be lowest when the vitamin content of the dairy products was highest. This study is well illustrated in Figure 135, which shows vitamin and sunshine curves for the various latitudes and the mortality curves by months for heart disease and pneumonia combined.
Many facts are revealed in this extensive study. Note, for example, how much higher the vitamin curves are for the north than for the regions farther south ; also, how much lower the vitamin curves are in the eastern states and far west where the soil has been tilled the longest.
Simultaneously, dairy products were obtained for analysis from several countries in the southern hemisphere, chiefly, Australia, New Zealand, and Brazil. These again showed the distinct seasonal variation in vitamin A and activator X content of the dairy products, which were, similarly, in the opposite phase for heart disease and pneumonia. The curves, however, for the southern hemisphere were in the phase opposite to those of the northern hemisphere, but were parallel with the seasons.
As these data were developed, preliminary reports were made from time to time in current scientific journals. These reports are summarized in the bibliography. While it is clearly not possible to review the steps of progress in detail in this communication, certain essential facts are presented briefly, with illustrations. I have been deeply indebted to national, state and provincial officials, also to individuals in the United States, Canada, Australia and New Zealand, for continuous cooperation extending over several years. This assistance has made it possible to develop curves showing comparative values from month to month and from year to year.
In the early part of this work, progress was slow in the differentiation of those activating substances that were identified as vitamins and given alphabetical numbers. Little was known of their nutritional properties. It was early discovered in the history of mineral utilization that one of the most striking manifestations was involved in rickets; and since the therapeutic use of ergosterol that had been exposed to ultraviolet radiation resulted in rapid healing of rickets, being comparable to exposure of the individual to sunlight or suitable artificial radiation, that substance was given the identifying name of vitamin D and was assumed to have the total responsibility for mineral utilization in bone and tooth formation and maintenance. The substance was given the name of viosterol in the United States. It did not prove efficient, however, in the control of dental caries.
Much progress has been made in recent years in identifying four different vitamin D factors, of which viosterol or irradiated ergosterol is vitamin D.’ Vitamin D3 is produced by the irradiation of a form of cholesterol. It is now recognized that activated ergosterol D2 does not represent the factors essential for the utilization of calcium and phosphorus by the human body. Available data indicate that it is not a product of animal bodies. We accordingly are concerned with data that will relate to mineral metabolism in general and dental caries in particular.
I have found in these studies that, in the control of dental caries, while the consumption of whole butter is an aid in mineral metabolism, greater potency may be obtained by melting a high vitamin butter and allowing it to crystallize for twenty-four hours at a temperature of about 70 degrees. It is then centrifuged, and, under the process, it separates into an oil that is limpid at that temperature, with a solid crystalline layer below. This oil is much higher in the activating factor than the whole butter. It is this substance that I shall refer to in this communication, unless otherwise explained, as a source of activator X.
Fig. 136-Treatment of rickets in rats by adding 2 per cent of butter-oil concentrate containing activator X to deficiency diet. Healing of rickets in the carpal and tail bones of rat No. 2 and improvement in blood minerals are marked.
There are many expressions of disturbed mineral metabolism in both the soft and the hard tissues of the body. Those of the skeleton are most easily demonstrated. Rickets in young children and animals is easily demonstrated by the roentgen rays and the progress in its healing is readily measured by this means.
Rats are used largely for testing the efficiency of various treatments for rickets. The effect of administration of activator X on rickets is striking.
In Figure 136 will be seen the roentgenographic appearance of the forelegs and the tails of two rats on the same deficiency diet; namely, Steenbock 2965. It will immediately be seen that all of the bones of No. 1 are very transparent and the carpal bones have not formed. The junction of the epiphyses and the diaphyses of the bones, especially of the tail, is shown to be characterized by a zone of separation. In rat No. 2, there is a marked density of the bones, seen as an area of opacity to the roentgen rays, and the carpal bones are well formed. The head of the humerus and the epiphyseal zones of provisional growth of the tail are well calcified, with only a line of separation between them and the diaphyses. This rat received, as an addition to the deficient diet, 2 per cent of the diet as a butter-oil concentrate obtained from a high vitamin butter. Clinically, this condition constitutes healed rickets. The quantity of this butter used would constitute only about one-half ounce for a child eating 2 pounds of food per day. This is a very small quantity for a growing child. To the right in Figure 136 will be seen the mineral levels in the blood serum of these two rats. The calcium for rat No. 1 is at 6.26 mg. per hundred cubic centimeters, and in rat No. 2, it is 8.4. The inorganic phosphorus in rat No. 1 is at 1.93 mg. per hundred cubic centimeters and in rat No. 2, it is 2.5 mg. We see at once that this clinical condition in these two rats is attended by marked correction of the blood chemical levels.
The product that was administered to rat No. 2 is a normal constituent of a normal milk, Nature’s only complete diet for mammalian infants and by far the most important single item of food for growing human beings in all periods of stress.
I shall use as illustration of a case profiting by the use of this dietary factor, the case of a boy 4 years of age (Fig. 93, page 270), brought to me with a fracture. He was in a cast. Rampant tooth decay was present. The diet had consisted of white bread and skimmed milk, which had been the source of his nutrition for an extended period owing to the poverty of the family at the time of the depression. He had been suffering from convulsions, which had been increasing in severity over a period of eight months. His leg had been broken when he had fallen to the floor in one of his convulsions three months before receiving the reinforced diet. The minister who brought him to me had been called to the home to baptize the boy for burial because he was considered so near death.
The only treatment given was a change in diet from skimmed milk and white bread to whole milk and a gruel made of freshly ground whole wheat. Over this gruel was poured about a desert spoonful of butter oil from a sample of butter that had been produced when the cows were eating rapidly growing green wheat. After his first meal, the boy slept his first night without a convulsion. He was fed five times the next day on the same diet, and had no convulsions. Recovery was very rapid.
Figure 93 shows the broken leg before and after the use of the reinforced diet for one month. The x-ray film shows the healed fracture. The patient had been taken out of the cast the day before. The x-ray film of the broken femur shows clearly the healing of the fracture. The photograph is indicative of the excellent physical condition of the child. Without operation on his teeth, dental caries was controlled. He grew to be an athletic young man, active in sports, particularly baseball.
During the severe industrial depression, rampant caries developed in a great number of cases in the families of mill workers. Children in these families provided excellent clinical material. A typical result of work done for these families is shown in a study of an experimental group of twenty-seven mission children selected on the basis of rampant dental caries. At the beginning of the test, in the average chemical analysis of all of the saliva specimens of the group, the inorganic phosphorus had passed from the powdered bone in an amount of 2.4 per cent of the total inorganic phosphorus of the saliva. In two months, this condition changed to a movement toward the powdered bone averaging 3.42 per cent of inorganic phosphorus for the entire group; in four months, to 8.13 per cent; in five months, to 11.36 per cent, and in seven months, to 11.75 per cent.
Since these children were all from poor homes, many of the families being on relief, one extra good meal a day at midday was provided for the entire group at the mission. This was preceded by administration to each child of one teaspoonful of a mixture containing a high vitamin butter oil obtained by centrifuging the butter at 70 degrees from a twenty-four hour crystallization of the melted butter. This butter was selected on the basis of its high content of activator X. It was mixed with equal parts of a high-vitamin, natural cod-liver oil. The clinical effect was apparent complete control of dental caries for the entire group, as shown in the films. In x-ray of these cases, many the open cavities were left without fillings; and, in all such cases, the exposed dentin took on a hard glassy finish. There were many other evidences of betterment.
One of the boys, who was so weak at the beginning of the test that it was considered questionable whether it was safe for him to walk the two blocks from his home to the mission for the one reinforced meal a day, in six weeks was able to play basketball. He was dashing about as a star player, and there was no evidence of undue fatigue on his part in this strenuous game.
Under the stress of the industrial depression, the family dietary for the children in this mission group was very deficient. During the experiment, the home meals were not changed, nor was the home care of the teeth. The preliminary studies of each child included complete x-ray examination of all the teeth, chemical analyses of the saliva, a careful plotting of the position, size and depth of all cavities, a record of the height and weight and a record of school grades, including deportment. It is important to note that the home diet which had been responsible for the tooth decay, was exceedingly low in body-building and repair material and high in sweets and refined starches. It usually consisted of a highly sweetened coffee and white bread, vegetable fat, pancakes made of a white flour and eaten with syrup and doughnuts fried in vegetable fat. The diet provided these children in the supplemental meal was as follows: About 4 ounces of tomato juice or orange juice and a teaspoonful of a mixture of equal parts of a very high vitamin, natural cod-liver oil and an especially high vitamin butter oil was given at the beginning of the meal. The child then received a bowl containing approximately a pint of a very rich vegetable and meat stew, made largely from bone marrow and fine cuts of tender meat. The meat was usually broiled separately to retain its juice and then chopped very fine and added to the bone-marrow meat soup, which always contained finely chopped vegetables and plenty of very yellow carrots. The next course consisted of cooked fruit, with very little sweetening, and rolls made from freshly ground whole wheat and spread with high vitamin butter. The wheat for the rolls was ground fresh every day in a motor-driven coffee mill. Each child was given also 2 glasses of fresh whole milk. The menu was varied from day to day by substituting for the meat stew fish chowder or organs of animals. From time to time, food similar to that eaten by the children was placed in a 2-quart jar and brought to my laboratory, where chemical analysis showed that these meals provided approximately 1.48 gm. of calcium and 1.28 gm. of phosphorus in a single helping of each course. Since many of the children took “seconds,” their intake of these minerals was much higher. Since the accepted figures for the requirements of the body for calcium and phosphorus are 0.68 gm. of calcium and 1.32 gm. of phosphorus, it is obvious that this one meal a day, plus the other two meals at home, provided a factor of safety. Clinically, this program completely controlled the dental caries of each member of the group, as determined by x-ray and explorer examination.
It is important to note with regard to the effect of the special nutritional program on this group of mission children that two different teachers came to me to inquire as to what had been done to make a particular child change from one of the poorest in the class in capacity to learn to one of the best. Dental caries is only one of the many expressions of our modern deficient nutrition.
An example of the change produced in the structure of the teeth as a result of the reinforced nutrition in this mission group is illustrated in Figure 97, page 289, which shows three first permanent molars in which caries apparently had decalcified the dentin to the vicinity of the pulp chamber, causing exposure. The pulps were still vital. It will be noted at the left, in Figure 97, that each of the three molars apparently had an exposure of the pulp. In the views to the right, a progressive filling in of the pulp chambers can be noted from a deposition of secondary dentin, making a roof over the pulp and thereby providing a protection which enabled the pulp to remain vital and useful for an extended period. This is frequently experienced as a result of reinforcing the diet with highvitamin and high-activator butter, together with reducing the carbohydrate intake to a normal level as supplied by natural foods and by increasing the foods that provide body-building and tooth-forming minerals. The condition that obtains in the tooth is one in which the minerals cease to be taken in minute amounts from the tooth structure and, owing to the change in the saliva, the minerals in ionic form pass from the saliva bathing the tooth cavity into the demineralized dentin, in many cases a hard and even glassy surface resulting.
It is important to keep in mind that silver nitrate will not penetrate appreciably into tooth enamel after the tooth has been erupted for a year or more, in a normal mouth with normal saliva and high immunity to dental caries, though it will penetrate an appreciable distance in a recently extracted tooth in the same mouth. This experiment is easily made with impacted third molars, in which silver nitrate will often penetrate a millimeter into the enamel.
An excellent illustration of the rescue of a large number of apparently doomed teeth in the same mouth is shown in Figure 137. The patient, a girl aged 14, had lost all four of the first permanent molars and the diagnosis made by her local dentist indicated the necessity of removing all of the erupted teeth and the construction of two artificial dentures. Studies indicated that she had forty-two open cavities in twenty-four teeth in addition to fillings. The patient was placed on a reinforced diet including approximately one-half teaspoonful of a mixture of a high vitamin A and high-activator X butter oil mixed with equal parts of a very high vitamin natural cod-liver oil taken in capsules three times a day. She was on this regimen for about seven months, with the result that there was very little evidence of extension of the caries, notwithstanding that no fillings were placed, with the exception of two or three temporary ones. The condition of these teeth before the dietary change is shown in the two upper rows of Figure 137.
Fig. 137 – Case of girl who had forty-two cavities in twenty-four teeth. With the diet reinforced with activator X, the pulp chambers built in secondary dentin and all the teeth were saved. Full dentures had been recommended.
Because of the extreme severity and extent of the dental operations needed, restoration was not undertaken locally, but the patient was sent to Cleveland from a southern state; also for the management and care of her case. The operative program was completed by my associate Dr. Richard Spayde. The roots of three of the straight-rooted teeth with extensive pulp exposure were filled. Another tooth had had its roots filled before the patient came to me. The lower two rows of teeth show them as restored.
This girl, at 15, had all her teeth, with the exception of the four first permanent molars, extracted earlier in life. The teeth have been well restored with good masticating surfaces and the appearance of the patient is excellent. She is so enthusiastic that she wishes to give lectures on nutrition to aid others with their dental problems. Important light is thrown on this case by both the chemical analysis of the saliva and the bacterial count. The inorganic phosphorus of the saliva, shaken with powdered bone, was changed from +19.1 to -29.5. The bacterial count change for L. acidophilous was from 680,000 to none.
This form of nutritional control of dental caries is so satisfactory that I can recommend it with confidence as adequate to control well over 95 per cent of dental caries, in the hands of painstaking, efficient and informed dentists.
During the years that these investigations on the nature and source of this special activating substance in butter, which I have called activator X, have been in progress, no reports have been noted from other workers of its discovery until the last few years. Then Schantz, Elvehjem and Harts reported the comparative nutritive value of butter fat and certain vegetable oils. Their data were summarized in Dairy Council Digest, March 1940, as follows:
A series of feeding experiments on rats showed differences in the nutritive value of common fats. The rats which received butter fat grew better than the rats fed vegetable oils, were better in appearance, and had better reproductive capacity. Apparently butter fat contains a substance not present in the other fats tested, which is essential for the growth and health of young animals. This difference is not due to vitamins A, D, or E, but to a difference in the chemical constitution of the fats. These findings are significant to the knowledge of nutrition because they indicate additional reasons why milk fat has superior value for human diets.
Hart emphasizes the importance of these findings. He says:
Milk is indispensable for the best nutrition of children and serves as a concentrated protective source of nutritional essentials for all ages. This being true, dairying must continue as a part of our agriculture if our standards of living are to be maintained. A people without milk and in general the means to make a better milk, must suffer from high infant mortality, poor child nutrition, and forego the liberal use of a product so nearly complete in all nutritional factors. Milk is the one food with a liberal concentration of all the nutrients, except a small number of minerals, that can claim the distinction of protecting against deficiency diets. It can be improved by better feeding. But the mammary gland in its distinctive synthetic capacity and as a concentrator elaborates a commercial and readily available product for which there is no equally effective substitute.
Hart and his group later reported additional data under the title “Rations for the Study of the Relative Nutritive Value of Fats and Oils.” Science Dec. 3, 1943, which he summarized as follows: “It is apparent that lactose has an as yet unknown effect on intestinal conditions which is counteracted by butter but not by corn oil.”
Dec. 1943 he reported further studies in the Journal of Nutrition, under the title, “Further Studies on the Comparative Value of Butter Fat, Vegetable Oils, and Oleomargarines,” which he summarized as follows:
1. “With lactose as the sole carbohydrate in the diet, rats showed superior growth when fed butter fat or lard as compared to corn oil, coconut oil, cottonseed oil, soybean oil, peanut oil, olive oil and hydrogenated cottonseed oil.
- With a mixture of carbohydrates composed of sucrose, starch, dextrose, dextrin, and lactose in the diet, the average growth response of the animals fed vegetable oils was equal to that of the animals fed butter fat and lard. The growth rate on this ration was more rapid than when all of the carbohydrate present was lactose.
- Properly fortified oleomargarine fats had growth potential equal to butter fat over a period of 6 weeks when the above mixture of carbohydrates was incorporated in the rations.
- Properly fortified oleomargarines did not give growth equal to butter fat when lactose was the sole carbohydrate in the diet. On such a regime rats fed butter fat grew slightly better than rats fed oleomargarines of animal origin, but decidedly better than rats fed oleomargarines of vegetable origin.”
Another group of workers using calves as the experimental animals has recently reported a similar superiority of butterfat in feeding trials. T. W. Gullickson, F. C. Fountaine and J. B. Fitch, of the Division of Dairy Husbandry, University of Minnesota, used animal and vegetable fats with skimmed milk, with the following results:
Feeding tests were conducted to compare the feeding value of the following fats and oils for calves: butterfat, lard, tallow, coconut oil, peanut oil, corn oil, cottonseed oil, and soybean oil. . . . In average daily gain in weight as well as in general well-being, the calves fed butterfat excelled those in all other groups. Following closely were those receiving lard and tallow. Corn oil, cottonseed oil and soybean oil were the least satisfactory. They appeared unthrifty, listless and emaciated. Some calves in these groups died and others were saved only by changing to whole milk.
We are concerned to note the probable relationship between the factor that has been disclosed by the Wisconsin and Minnesota groups and my activator X and vitamin A. Table I shows the relation of activator X and vitamin A to butterfat structure as reported by the Wisconsin Group, which shows the comparative readings in six spaced samples of butter produced by the same cows. This herd was fed in Deaf Smith County of northwest Texas near Hereford. The samples were obtained about ten days apart, beginning with February and extending through to April. In March, the fodder was reinforced with green alfalfa hay.
TABLE 1.- Relation of Activatior X TO VITAMIN A AND BUTTER FAT STRUCTURE*
*Data on six ten-day samples of cream from same herd, near Hereford, Texas, showing marked increase in both nutritional factor reported by Wisconsin group and activator X factor, strongly indicating that they are the same.
It will be noted that all of the factors, namely the saponification number, iodine number, vitamin A and activator X, progressed through a wide range and are in general parallel. The addition of the green pasture also produced a marked change in the color of the butterfat. The first two samples of butter, when separated from the cream, were as white as lard. A very slight tint was showing in the third sample, which increased progressively to a brilliant golden yellow through the next three samples. The relation of the changes in these four factors to each other and to the green pasture addition to their fodder is shown graphically in Figure 138, which also shows a change in the color of the butter as photographed on panchromatic plates. It will be noted that the evidence is very striking in that the factor which I have been studying and referring to as activator X is possibly the same factor that has recently been observed and reported by both the Wisconsin and the Minnesota groups.
Fig. 138. Above: Four butter factors, saponification number, iodine number, vitamin A and activator X graphically shown. There was a rapid rise of all when green pasturage was added. Below: Difference in natural color of butters.
It is important that we observe the effect of the administration of the activator X factor to patients suffering with rampant dental caries on the incidence of caries, the change in chemical analysis of the saliva and L. acidophilous growth. I have previously reported that in the inorganic phosphorous of the saliva, as determined by an adaptation of the Kuttner and Cohen’ technic for blood, in which the proteins of the saliva are precipitated by sodium acid molybdate and trichloracetic acid, there is a marked change in the behavior of the phosphate ions of the saliva when it is shaken with powdered bone or powdered tooth substance. In the mouths of susceptible individuals, the inorganic phosphorous is increased by transfer of the phosphate ions from the powdered bone or tooth chips, whereas, in normal saliva of patients with immunity to dental caries, the movement is from the saliva to the negative absorbent; namely, powdered bone or tooth chips. This is graphically shown in Figure 139 for a group of six typical cases.
SALIVA CHANGES WITH VITAMIN A AND ACTIVATOR I
Fig. 139. Six typical cases in which, under phosphorus factor changed from average of count fell from 323,000 to 15,000.
In this group, the saliva, before the treatment began, gained 11.5 per cent in inorganic phosphorus; whereas, after treatment, the saliva lost 13.9 per cent of its inorganic phosphorus. The change in nutrition included an increase in the activator X and vitamin A content as concentrated from a high vitamin butter and a reduction in carbohydrates; also an increase in mineral-providing foods. Before the change in nutrition, when the tooth decay was considered active, L. acidolphilous averaged, for the group, 323,000 colonies per cubic centimeter of saliva, and, after treatment, averaged 15,000. These data are typical of many hundreds of clinical cases in which dental caries has been reduced apparently to zero, as indicated by both x-ray and instrumental examination.
We human beings of modern civilization are at a great disadvantage in the selection of foods in that we seem to have lost a sixth sense by which we would recognize a specific need for special food. Many of the primitive races and most animals retain the capacity to satisfy the body needs by choosing the foods that will provide minerals and vitamins. This is well illustrated in one of my experiments with chickens.
Three brooders, each carrying twenty-five chickens, 3 days old, were provided with a diet of grain. No opportunity was given the chicks to supplement the diet, as chickens in the open or birds in the wild can supplement theirs by picking up green food and insects. In order to provide an additional source of food, each brooder was supplied with a measured quantity of butter selected on the basis of its vitamin A and activator X content.
BLOOD CHANGES IN CHICKS WITH THREE GRADES OF BUTTER
Fig. 140.—Changes in blood of chicks depending on vitamin A and activator X content. The product of serum calcium and serum inorganic phosphorus went up when both were used and fell to a low level when butter with low vitamin A and activator X content was used.
Brooder No. 1 had a butter that was high in both vitamin A and activator X; brooder No. 2, a butter high in vitamin A and low in activator X, and brooder No. 3, a butter low in vitamin A and activator X. It was observed that the chicks in brooder No. 1 developed much better than those in either of the two other brooders even though the vitamin A content was high in both brooder No. 1 and brooder No. 2. An important part of the experiment was observation of the effect of these diets on the chemical content of the blood. On the eighth day, a sufficient number of chickens were killed for blood tests to determine the level of the product of serum calcium and serum inorganic phosphorus. (CaXP)
A product of 40 is considered normal for most species. At the beginning of the test, this factor stood at 29.7. On the eighth day, for the chickens receiving the butter high in both vitamin A and activator X, this factor had increased to 31.2; for the chicks in brooder No. 2, receiving the butter high in vitamin A and low in activator X, it decreased to 28.8, and for those in brooder No. 3, receiving the butter low in both vitamin A and activator X, it had fallen to 17.8. On the twentieth day, this progressive change was even more marked, being at 32 for the chicks receiving butter high in both vitamin A and activator X and at 25 for those receiving butter high in vitamin A and low in activator X. For those receiving butter low in both vitamin A and activator X, this product of serum calcium and serum inorganic phosphorus had fallen to 13. This result is strikingly illustrated in Figure 140.
The significance of these data is very great since they throw an important light on the lowering of the level of defense for many of our modern degenerative processes, including dental caries.
An important observation was made with regard to the behavior of the chicks in these three groups, particularly as to the amount of the butter they consumed and the effect on their general health. It was noted that the chicks in pen No. 1 ate much more butter than those in either pen No. 2 or pen No. 3. This suggested the desirability of making an observation of the ability of the chickens to select from three samples of food the one that was highest in vitamin A and activator X. Accordingly, a new group of forty chickens was started in a large brooder. The same deficient diet was used and three containers supplying the same three grades of butter were placed in the large brooder, fresh each day. The butter was weighed before and after each feeding and the containers were shifted to different parts of the brooder so that the same grade of butter was not in the same place twice in succession. This was repeated for fifty-seven days, when it was found that the chickens selected and ate about two and one-half times as much of the high activator X butter as of the low. I could not distinguish between these butters, nor could any member of my staff. This clearly indicated an ability on the part of the chicks to select the best food.
An important modification of this chick experiment related to the capacity of this butter vitamin and activator to maintain life. The same three grades of butter were used and the chicks were on McCollum’s deficiency diet 3142. When 28 per cent of the chicks had died in the pen with the low vitamin A and low activator X butter, only 16 per cent had died in the group receiving butter high in vitamin A and low in activator X, and none had died in the pen with the butter high in both vitamin A and activator X. When 72 per cent of the chicks were dead in group 3, 53 per cent were dead in group 2 and only 24 per cent in group 1.
It has generally been assumed that cod-liver oil is an adequate source of the fat-soluble vitamins, but that this is not true for human beings, animals or birds is readily illustrated by the following experiment in which turkeys were used that were afflicted with weak legs. Three groups of turkeys were used. Those in pen No. 1 were controls; those in pen No. 2 received cod-liver oil in addition to the stock food on which they were being fed, and those in pen No. 3 received in addition to foods mentioned butter high in vitamin A and activator X. After a seven-day period, the controls had gained only 8.3 per cent in weight and those in pen No. 2, on cod-liver oil as an addition to the stock food, had gained 16.7 per cent; while those in pen No. 3, receiving in addition the high vitamin A and activator X butter, gained 37.5 per cent in weight, more than twice the gain of those in pen No. 2 and more than four times that of the controls in pen No. 1. The difference in their appearance and condition is shown in Figure 141. We are concerned to note the changes in the blood. The calcium and phosphorus increase is shown graphically at the right in Figure 141. The calcium increased 2 mg. in groups 2 and 3, the phosphorus, 1 mg. in group 3.
Space does not permit a detailed presentation of my experimental studies showing the direct relationships among the soil, chemical content, the plants produced by the soil and the effect of those foods on human beings and animals.*
Interpretation of these data in relation to current thought regarding the etiology and control of dental caries requires strong emphasis on the need for a broader view than is involved in the interpretation that dental caries is purely a local problem in the mouth and soley due to the presence and activity of aciduric organisms propagated by favorable pabulum supplied in the food and chiefly by sugar. It is also strongly indicated that we must not think of dental caries in terms of oral hygiene, as important as that process is.
My studies of fourteen primitive racial stocks in various parts of the world, selected on the basis of their unique physical environment, have
Fig. 141.-Young turkeys which, when fed on stock food, rapidly developed weak legs. They recovered much more rapidly with activator X and cod liver oil than with cod liver oil alone, as shown in the photograph. The gain in weight was twice as great in seven days as were the gains in the cod liver oil group and four times as great as that of the control group. The graph shows the changes in amounts of calcium and phosphorus.
shown that where isolated and dependent on their native foods, selected in accordance with the accumulated wisdom of the racial stock, people are relatively free from dental caries. This was true notwithstanding the fact that almost no effort was made at oral hygiene. At their point of contact with the foods of modern civilization, they rapidly lost their immunity, in large part because of the high sugar and refined starch content, which provided pabulum. However, many other expressions of degeneration appeared besides dental caries. The percentages of teeth attacked by dental caries in these groups, the more isolated as compared with the modernized, are shown in Table 2.
Table 2.-Percentages of Teeth ATTACKED BY CARIES IN PRIMITIVE AND MODERNIZED GROUPS
On the basis of the chemical analysis of the foods, it was disclosed as shown in previous chapters that the primitive diets of these various groups in various environments all indicated a high content of minerals and vitamins, including activator X. I have reported these data in several communications.”
Table 1 and Figure 138, above, show the chemical characteristics of butters produced in Deaf Smith County, Texas. Much publicity has been given to the observation that dental caries had a much lower incidence in the town of Hereford than in most other districts in the United States. It is of special interest that during the years that I have been obtaining butter samples from various parts of the United States and Canada and several other countries, I have been making a special study of the dairy products in the immediate district of northwest Texas and eastern New Mexico in the adjoining counties of Curry, New Mexico and Deaf Smith County, Texas. On the basis of the samples of butter received from these counties and analyzed, during 14 years, when I had butter shipped to Cleveland because of its very high content of activator X and vitamin A to use in my experimental groups of human beings and animals I found its use highly effective in the control of human dental caries, when accompanied by an adequately adjusted food intake. During these years, it has been found that the high level of activator X and vitamin A was directly associated with the specially favorable pasturage, chiefly wheat grass and other cereal grasses and alfalfa in a lush green state of growth. The cows were pastured on this wheat grass during the fall, winter and spring until time for the wheat plants to stalk. The winter wheat was usually sown in August.
In the immediate districts in which the specially high vitamin butter was produced by this pasturage, it has now been shown that the butter content is directly related to the soil. Excavations to trace the wheat roots show that they pass down 6 feet or more through 3 feet of top soil, varying in depth, into a caliche soil which is very rich in calcium. This caliche consists of glacial pebbles cemented together with calcium carbonate. All of the plants growing on these areas that have this soil foundation are particularly rich in minerals and vitamins.
I have obtained samples of wheat from thirteen districts surrounding Hereford for chemical analysis. It is of interest that while these samples all show a relatively high level of thiamine, vitamin B’, there is still a marked variation which is not related directly to the protein, calcium or phosphorus content.
Farm stock produced in this area has a much higher market value and a greater capacity for reproduction than the stock in most states. The capacity of most of our states for supporting domestic animals has progressively decreased until, in many districts, the capacity of the farms has gone down to about 50 per cent. When animal life degenerates because of inadequate food, human beings react similarly. The data disclose a physical basis for our modern physical degeneration including dental caries.
- Data have been presented revealing a wide range of nutritive factors, one of which has not been generally recognized and to which, for want of an accepted identification, I have referred as activator X. This is found in the food fats of animal origin and is particularly high in butterfat when dairy animals are eating lush green pasturage directly or rapidly cured and stored for stall feeding.
- Data have been presented indicating that this factor, activator X, plays an important role in such vital processes as the control of dental caries and the healing of fractured bones.
- It has been shown that dairy products in Hereford vicinity may vary through a range of fiftyfold in a few weeks’ time in the vitamin A and activator X content, the range depending directly on the fodder. There is a sharp rise at the time that the green pasturage is added to the ration of the cows.
- This factor, which I have discovered in my investigations of butterfats, gives strong evidence of being the same factor that has recently been announced by the Dairy Department of the University of Wisconsin and of the University of Minnesota, which they identify by determining the saponification number and iodine number and by animal feeding.
- The addition of butter high in activator X to the diets of human beings suffering from tooth decay causes a marked change in the chemical constituents of the saliva and the growth of L. acidophilous.
- Data have been presented indicating that chickens have the ability to recognize and select butters high in activator X and that this prolongs their lives.
- Turkeys are shown to grow much more rapidly when this factor is available in their food than when cod-liver oil alone is used, and its addition to their diet prevents and cures weak legs.
- Clinically, the use of butter high in activator X, in conjunction with a favorable selection of natural foods, as shown through a period of seventeen years, is highly effective in the control of dental caries.
- Primitive races controlled dental caries with diets high in body building factors which included activator X.
- Yoder, L.: Relation Between Peroxidation and Anti-Rachitic Vitamins. J. Biol,
Chem., 70:297, October 1926.
- Price, W. A.: Seasonal Variations in Butter-Fat Vitamins and Their Relation to Seasonal Morbidity, Including Dental Caries and Disturbed Calcification. J.A.D.A., 17:850-873, May 1930.
- Idem: Calcium and Phosphorus Utilization in Health and Disease: 1. Role of Activators for Calcium and Phosphorus Metabolism. Domin. D. J., 41:315, October 1929. 2. Nature and Source of Calcium and Phosphorus Activators. Ibid., 41:351, November 1929.
- Carr, F. H., and Price, E. A.: Biochem. J., 20:497-501, 1926.
- SCHANTZ, E. J.; ELVEHJEM, C. A., and HART, E. B.: J. Dairy Sc., 23:181, 1940. 6. GULLICKSON, T. V.; FOUNTAINE, F. C., and FITCH, J. B.: J. Dairy Sc., 25:2, February 1942.
- Kuttner, T., and COHEN, H.; Microcolorimetric Studies. 1. Molybdic Acid, Stannous Chloride Reagent. J. Biol, Chem., 75:517, November 1927.
- PRICE, W. A.: Control of Dental Caries and Some Associated Degenerative Process Through Reinforcement of Diet with Special Activators. J.A.D.A., 19:1339, August 1932.
- IDEM: Nutrition and Physical Degeneration: Comparison of Primitive and Modern Diets and Their Effects. New York: Paul Hoeber, Inc. (Medical Book Department of Harper and Brothers), 1939.